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1. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s' ov.or ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designs d 0 tor* Inspection Date: <br /> SEA - $ <br /> Facility address: U5 , <br /> T V 1:4'[ � ��� Product -614 <br /> Facility Conta Title: Phone: r • , <br /> 11 <br /> aMonitoring Panel: Piping system: Overfill prevention: <br /> {t?PM1mQX t1J' '� PressurizedG.-❑Suction ❑Gravit ❑Mechanical Audible/visual <br /> Inspection type: Violations: <br /> Routine Monitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev Q M-3 13oth <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 6 Monitoring Program(Monitoring&Response Plan is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring plan is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Dai!y monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> I 0 CCR 2632(c)(2) UST monitoring system is present M1) <br /> I l CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1) <br /> 12 HSC 25291 b UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 I Continuous monitoring s stem for underground piping&UDC is present M 1 <br /> 14 CCR 2631 a Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in seconds i in flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s) are installed M! <br /> l8 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Rccording/EMortin&of unauthorized releases ML <br /> 23 CCR 2715 Designated Operator: a)Statement from UST owner; (c-e)Month!y inspection, t)Employee training <br /> 24 CCR 2638 tal Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test M l) <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janus 1, 1984) (M 1) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Pennit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system_ <br /> 34 HSC 25298 b) Permit to temporarily close UST system <br /> 35 HSC 25298 c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 2529$ a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INVECTOR: C PHONE: _r� UEC <br /> SSeptic system: <br /> Serves>_20 peoplelday <br /> RECEIVED TITLE: - Receives other than sanitary waste <br /> Other disposal methods: <br /> Drywells/French drains <br /> EHD 2M2.002 REV 05/07 <br />